Acral Dedifferentiated Chondrosarcoma: Report of a Case Arising in the Proximal Phalanx of the Fourth Finger

2021 ◽  
pp. 106689692110102
Author(s):  
Raffaele Gaeta ◽  
Giacomo Aringhieri ◽  
Virna Zampa ◽  
Antonio D’Arienzo ◽  
Lorenzo Andreani ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Cellular Proliferation ◽  
Lung Metastases ◽  
Proximal Phalanx ◽  
Final Diagnosis ◽  
Local Relapse ◽  
Dedifferentiated Chondrosarcoma ◽  
Intralesional Curettage ◽  
Fourth Finger ◽  
Isocitrate Dehydrogenase 2

Dedifferentiated chondrosarcoma is a well-recognized entity, but its occurrence in the distal extremities is exceedingly rare. We present the case of a 49-year-old woman who experienced local recurrence of an “enchondroma” of the proximal phalanx of the fourth finger of the left hand, which had been initially treated with intralesional curettage at another hospital 4 years before, and 1 year before for a local recurrence. The imaging findings indicated an aggressive behavior, and an incisional biopsy showed a highly cellular proliferation of spindle and pleomorphic elements without evidence of matrix production intermixed with few fragments of a well-differentiated cartilaginous neoplasm with bland cellular atypia, focal nuclear hyperchromatism, and binucleation. An isocitrate dehydrogenase 2 R172S mutation was detected. The final diagnosis was dedifferentiated chondrosarcoma. Despite amputation of the fourth finger, the patient developed lung metastases and further local relapse. Recurrent cartilaginous tumors of the extremities should not be underestimated and should be followed in view of the possible acquisition of aggressive clinical behavior.

The role of Denosumab in joint preservation for patients with giant cell tumour of bone

2021 ◽  
Vol 103-B (1) ◽  
pp. 184-191
Author(s):  
David Louis Perrin ◽  
Julia D. Visgauss ◽  
David A. Wilson ◽  
Anthony M. Griffin ◽  
Albiruni R. Abdul Razak ◽  
...  
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Lung Metastases ◽  
Cell Tumour ◽  
Joint Surface ◽  
Intralesional Curettage ◽  
Tissue Mass

Aims Local recurrence remains a challenging and common problem following curettage and joint-sparing surgery for giant cell tumour of bone (GCTB). We previously reported a 15% local recurrence rate at a median follow-up of 30 months in 20 patients with high-risk GCTB treated with neoadjuvant Denosumab. The aim of this study was to determine if this initial favourable outcome following the use of Denosumab was maintained with longer follow-up. Methods Patients with GCTB of the limb considered high-risk for unsuccessful joint salvage, due to minimal periarticular and subchondral bone, large soft tissue mass, or pathological fracture, were treated with Denosumab followed by extended intralesional curettage with the goal of preserving the joint surface. Patients were followed for local recurrence, metastasis, and secondary sarcoma. Results A total of 25 patients with a mean age of 33.8 years (18 to 67) with high-risk GCTB received median six cycles of Denosumab before surgery. Tumours occurred most commonly around the knee (17/25, 68%). The median follow-up was 57 months (interquartile range (IQR) 13 to 88). The joint was salvaged in 23 patients (92%). Two required knee arthroplasty due to intra-articular fracture and arthritis. Local recurrence developed in 11 patients (44%) at a mean of 32.5 months (3 to 75) following surgery, of whom four underwent repeat curettage and joint salvage. One patient developed secondary osteosarcoma and another benign GCT lung metastases. Conclusion The use of Denosumab for joint salvage was associated with a higher than expected rate of local recurrence at 44%. Neoadjuvant Denosumab for joint-sparing procedures should be considered with caution in light of these results. Cite this article: Bone Joint J 2021;103-B(1):184–191.

scholarly journals Endoscopic-Ultrasound-Guided Tissue Sampling Facilitates the Detection of Local Recurrence and Extra Pelvic Metastasis in Pelvic Urologic Malignancy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ferga C. Gleeson ◽  
Jonathan E. Clain ◽  
R. Jeffrey Karnes ◽  
Elizabeth Rajan ◽  
Mark D. Topazian ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Local Recurrence ◽  
Endoscopic Ultrasound ◽  
Gold Standard ◽  
Final Diagnosis ◽  
Tissue Sampling ◽  
Invasive Method ◽  
Urologic Malignancy ◽  
Sensitivity Specificity

Pelvic lymph node dissection is the gold standard for assessing nodal disease in prostate or bladder cancer and is superior to CT, MRI and PET staging. Endoscopic ultrasound (EUS) provides an alternative, less invasive method of cytohistologic material acquisition, but its performance in pelvic urologic malignancy is unknown. Therefore, our aim was to evaluate the diagnostic accuracy of EUS guided tissue sampling for these malignancies when compared to a composite cytohistologic and surgical gold standard. A median of 3 FNA passes were performed (n=19 patients) revealing a sensitivity, specificity, PPV and NPV of 94.4% (72–99), 100% (2–100), 100% (80–100) and 50% (1–98) respectively. The perirectal space was the most frequently sampled location irrespective of the primary urological cancer origin. Final diagnosis established by EUS tissue sampling included bladder cancer (n=1), bladder cancer local recurrence (n=8), bladder cancer extra pelvic metastases (n=1), prostate cancer (n=2), prostate cancer local recurrence (n=4), prostate cancer extra pelvic metastases (n=1), testicular cancer extra pelvic metastases (n=1) and a benign seminal vesicle (n=1). EUS guided sampling of the gut wall, lymph nodes, or perirectal space yields suitable diagnostic material to establish the presence of primary, local recurrence or extra pelvic metastases of pelvic urologic malignancy.

scholarly journals Metastatic Pattern, Local Relapse, and Survival of Patients with Myxoid Liposarcoma: A Retrospective Study of 45 Patients

Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Hanna M. Fuglø ◽  
Katja Maretty-Nielsen ◽  
Dorrit Hovgaard ◽  
Johnny Ø. Keller ◽  
Akmal A. Safwat ◽  
...  
Keyword(s):  
Survival Data ◽  
Lung Metastases ◽  
Distant Metastases ◽  
Myxoid Liposarcoma ◽  
Local Relapse ◽  
Primary Diagnosis ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Metastatic Pattern ◽  
Observation Period

Purpose. To assess the metastatic pattern of the histological subtype myxoid liposarcoma (MLS) with no or few round cells.Methods. Forty-five patients (F/M = 27/18, mean age 49 (range 17–85) years) were diagnosed with MLS at two Danish sarcoma centres in the period 1995–2004. A retrospective review of patients' files combined with an extraction of survival data from the Danish Centralised Civil Register was performed.Results. Seven patients had distant metastases during the observation period. Two patients had metastases at the time of diagnosis, while metastases occurred within 2.5 years in four patients, and in one patient 11.9 years after primary diagnosis. All metastases occurred at extrapulmonary sites. The first local relapse occurred within 3 years after surgery in six patients, in one patient after 4.0 years, and in one patient 7.7 years after surgery. The 5- and 10-year overall survival was 80% and 69%, respectively. Both the 5- and 10-year distant metastases-free survival was, respectively, 86%. The 5- and 10-year local relapse-free survival was, respectively, 83% and 80%.Conclusions. Patients with MLS had only extra-pulmonary metastases, and no lung metastases were found. Most local relapses and distant metastases occurred within the first 2-3 years after surgery.

MRI assessment of the bone adjacent to giant cell tumours and its association with local recurrence after intralesional curettage

2018 ◽  
Vol 73 (11) ◽  
pp. 984.e19-984.e28
Author(s):  
Y. He ◽  
J. Wang ◽  
L. Du ◽  
F. Yuan ◽  
X. Ding ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Giant Cell ◽  
Intralesional Curettage ◽  
Giant Cell Tumours

scholarly journals An Unusual Case of Clear Cell Chondrosarcoma with Very Late Recurrence and Lung Metastases, 29 Years after Primary Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Minna Laitinen ◽  
Jyrki Nieminen ◽  
Toni-Karri Pakarinen
Keyword(s):  
Local Recurrence ◽  
Clear Cell ◽  
Lung Metastases ◽  
Extended Period ◽  
Late Recurrence ◽  
Bone Neoplasm ◽  
Low Grade ◽  
Clear Cell Chondrosarcoma ◽  
Primary Surgery ◽  
Additional Surgery

Clear cell chondrosarcoma is a rare bone neoplasm with low-grade clinical course and the potential to metastasize to the skeleton and lungs. The aim of this report is to present a case that is extremely rare, but in accordance with the literature where the clear cell chondrosarcoma reportedly has a tendency for late metastases. In our patient the primary surgery was intralesional, since it was mistakenly interpreted as a benign tumour in the early 80s. The local recurrence and lung metastases occurred, however, 29 years after the initial treatment. The local recurrence was resected with wide margins, no additional surgery or oncological treatments were given, and two and half years postoperatively patient is doing well and there is no progression in the disease. In conclusion, it is important to have a long follow-up to the clear cell chondrosarcoma patients even for decades or lifelong, because the malignancy tends to metastasize or recur after an extended period. The course of metastasized disease may be unusually slow, so relatively aggressive treatment in metastasized and recurring cases is justified.

scholarly journals Disease Extent ≥4 cm Is a Prognostic Marker of Local Recurrence in T1-2 Breast Cancer

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
D. Lindquist ◽  
D. Hellberg ◽  
T. Tot
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Breast Conserving Therapy ◽  
Local Relapse ◽  
Additional Treatment ◽  
Residual Cancer ◽  
Disease Extent ◽  
Surgical Specimen ◽  
The Status ◽  
Independent Marker

Despite improvements of the therapy for breast cancer, a proportion of the patients still get local recurrence. The status of the surgical margins is the most often used parameter for decision regarding additional treatment. However, a negative margin is not a guarantee that there is not residual cancer left in the breast; additional parameters are needed to better predict the risk of local recurrence. The disease extent was evaluated in the surgical specimen from 313 women after breast-conserving therapy using large-section histology and was correlated to the incidence of local recurrence. A disease extent ≥4 cm was shown to be an independent marker for local recurrence; the cumulative 10-year local relapse rate for the group with a disease extent ≥4 cm was 20.5%, and for the rest 6.7%. We conclude that disease extent ≥4 cm seems to be an important factor when evaluating the risk for local recurrence.

scholarly journals MULTIPARAMETRIC MRI IN PATIENTS WITH LOCALIZED PROSTATE CANCER AFTER RADICAL EXTERNAL RADIOTHERAPY

2019 ◽  
pp. 32-41
Author(s):  
M. V. Krupina ◽  
T. N. Trofimova ◽  
M. Y. Valkov
Keyword(s):  
Prostate Cancer ◽  
Local Recurrence ◽  
Current Knowledge ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Local Relapse ◽  
Multiparametric Mri ◽  
Imaging Method ◽  
External Beam ◽  
Local Progression

Prostate cancer (PC) is the one of the most common and socially significant malignancies in men. Radiotherapy is currently one of the leading conservative special treatments for a localized and locally advanced PC. The frequency of biochemical recurrence after external beam radiotherapy (EBRT) is high. One of the main problems is a differentiation between local and systemic relapse of PC. Nevertheless, a local recurrence of PC after radiotherapy can occur without increasing PSA. Magnetic resonance imaging (MRI) is a highly informative imaging method, however, currently it is used mostly for the primary diagnosis and is not included into the recommendations for detecting recurrent prostate cancer after treatment. MR-pattern of the local progression after radical EBRT can be similar to that of primary PC. It is also difficult to diagnose local relapse of prostate cancer in some cases. Multiparametric MRI (mpMRI) has the greatest prospects in the diagnosis of local tumor recurrence in prostate cancer patients after radical external beam radiotherapy. The article provides an overview of domestic and foreign literature, in which we attempted to systematize current knowledge about the possibilities of the mpMRI in diagnosing local recurrence after radical EBRT and, based on the results of published studies, identify directions for further application of this approach.

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